PLEASE PRINT OUT FORM AND COMPLETE IN BLOCK CAPITALS


Click here for a PDF of the brochure REGISTRATION FORM


Company: ______________________________________________________ Address: _______________________________________________________ _______________________________________________________________ Country: _______________________________________________________ Tel: ____________________________ Fax: ____________________________ VAT No.: __________________________________________________ (Must be completed by all EU Companies) Company activity: _______________________________________________ Purchase order No. (if applicable): _______________________________________ Invoice address (if different from above): _____________________________ ________________________________________________________ ________________________________________________________


DELEGATE DETAILS If more than one delegate please photocopy form


Title: _______________ First name: _________________________________ Surname: ______________________________________________________ Position: _______________________________________________________ Email: ________________________________________________________ Special dietary requirements: ________________________________________ Signature: ________________________ Date: ________________________


PAYMENT DETAILS All payments to be made in Euros Please tick box and write amount:


q Early bird admission fee: (Until 22nd July 2016)


q Admission fee thereafter: q Table top exhibition package:


(Includes 1 delegate place) q Conference Dinner:


€1090 + €218* = €1308


€1190 + €238* = €1428 €2000 + €218**= €2218


€90


(**Only admission fee part of package is VAT chargeable at 20%) *Austrian VAT charged at 20%


_________


_________ _________


_________ Total: _________ Please note all delegates have to pay the VAT stated above.


METHOD OF PAYMENT On receipt of this registration form your credit card will be debited. You will be sent an invoice in 7-14 working days.


q Bank transfer quoting: ‘Applied Market Information Ltd.- Polyolefin Additives 2016’ to: Commerzbank, Filiale Düsseldorf, Breite Straße 25, 40213 Düsseldorf, Germany Account number: 1024710


Bank No. 300 400 00 IBAN: DE93 3004 0000 0102 4710 00 SWIFT: COBADEFFXXX


q Visa / Mastercard / Eurocard / JCB -


- - If paying by card the following information must be given


Name of cardholder: _____________________________________________ Expiry date: ________________________ 3-digit security code: __________ Cardholder’s signature: ___________________________________________ Card billing address: _____________________________________________ Post / zip code: __________________________________________________


Country: _______________________________________________________


Tel: ____________________________ Fax: ____________________________ Email: ________________________________________________________


POLYOLEFIN ADDITIVES 2016 CONFERENCE INFORMATION


Date and location 13-15 September 2016 Imperial Riding School Renaissance Hotel Ungargasse 60 1030 Vienna Austria


Tel: +43 1 711 750 Fax: +43 1 711 75 8146


Registration fee The registration fee includes attendance at


all conference sessions, the


Welcome Cocktail Reception, lunch and refreshment breaks on both days and a set of conference proceedings.


• Early bird registration: Register before 22nd July 2016 for only €1090*. Thereafter the cost is €1190*.


• Group rates: For companies wishing to register two or more delegates, group discounts are available. Please contact the Conference Organiser for more


details. (Please note to qualify for the group discount delegates must be booked at the same time, otherwise additional delegates may be charged at full price).


Polyolefin Additives 2016 table top exhibition A limited number of table top exhibition spaces are available in the spacious lobby next to the main meeting room. The table top exhibition fee is excellent value for money and includes 1 delegate place. Exhibitors may either use tables provided by the hotel or bring their own stand or display.


Sponsor this event and promote your company A variety of sponsorship opportunities are available at this event that can help to promote and enhance your company’s products and services to this highly targeted international audience. For further information, please contact the Conference Organiser on: +44 (0) 117 314 8111.


Social events The social events organised for Polyolefin Additives 2016 will provide an ideal setting for delegates and speakers to mix business with pleasure.


• Welcome Cocktail Reception: A welcoming cocktail reception will be held on the first evening. All delegates are invited to attend and it will


offer an excellent opportunity to meet speakers and other colleagues. The Welcome Cocktail Reception will run approximately from 18.00 to 19.30 and is included in the delegate fee.


• Conference Dinner: All delegates are warmly invited to attend the Conference Dinner, which will take place at a local restaurant on the


evening of 14th September 2016. The additional cost is €90.


Hotel accommodation Delegates are responsible for booking their own accommodation. AMI has negotiated a limited number of rooms at the rate of €143.37 for a single room and €158.41 for a double (breakfast, Wi-Fi and taxes included) at the Imperial Riding School Renaissance Hotel in Vienna for a limited time only. Please make your reservation using the direct hyperlink which can be found on the Accommodation tab of the Polyolefin Additives 2016 webpage. Please visit www.amiplastics.com.


Cancellations Full


refunds, less a cancellation charge of €200 will only be made on


cancellations received prior to 12th August 2016. Thereafter we regret that no refunds can be made. Delegates may be substituted at any time. Please note that refunds will not be given on table top bookings, sponsorship packages or Conference Dinner places.


*+20% Austrian VAT


CONFERENCE HOTLINE NICOLA CHARLESWORTH, CONFERENCE ORGANISER Applied Market Information Ltd. 6 Pritchard Street, Bristol, BS2 8RH, United Kingdom Tel: +44 (0) 117 314 8111 Fax: +44 (0) 117 311 1534 Email: nc@amiplastics.com Twitter: @AMIconferences #attendAMI


The latest programme, including any new speakers or changes to the schedule can be viewed on our website: www.amiconferences.com


Fax back to: +44 (0) 117 311 1534 or Email: nc@amiplastics.com


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